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We report 3 patients with autopsy-proved Creutzfeldt-Jakob disease who, early in their course,developed abnormal eye movements that included periodic alternating nystagmus and slow vertical saccades.These findings suggested involvement of the cerebellar nodulus and uvula,and the brainstem reticular formation,respectively.Cerebellar ataxia was also an early manifestation and,in 1 patient,a frontal lobe brain biopsy was normal at a time when ocular motor and cerebellar signs were conspicuous. As the disease progressed,all saccades and quick phases of nystagmus were lost,but periodic alternating gaze deviation persisted.At autopsy,2 of the 3 patients had pronounced involvement of the cerebellum,especially of the midline structures.Creutzfeldt-Jakob disease should be considered in patients with subacute progressive neurological disease when cognitive changes are overshadowed by ocular motor findings or ataxia. |
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ataxia
cerebellar lesion
eye movement,disorders of
Jakob-Creutzfeldt disease
nystagmus
nystagmus,periodic alternating
ocular motility,disorders of
saccadic eye movements,abnormal
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